Fluorescence imaging, an emerging tool for preserving the parathyroid glands during thyroidectomy.

With vocal cord palsy, hypoparathyroidism is one of the two major complications after thyroid surgery. Traditional approaches to preserving the parathyroid glands during thyroid surgery include identifying the glands precisely and preserving their vasculature with the naked eye, which mainly depend on the experience and skill of the surgeon. Recently, a relatively new technique, fluorescence image-guided surgery, has been widely researched and is becoming increasingly popular. The authors present a video clip of transoral robotic total thyroidectomy, which shows the three typical statuses of the parathyroid glands after thyroid surgery (well-perfused, poorly or non-perfused, and congested) and explains how to deal with each status of the parathyroid glands.